Support for self care - Opportunistic advice and support to enable people to care for themselves or other family members.
Clinical governance – Requirements include use of standard operating procedures, ensuring compliance with the Disability Discrimination Act and following quality frameworks to ensure safe delivery of services
Advanced Services Currently the only Advanced Services which are commissioned nationally are Medicine Use Review (MUR), Appliance Use Review (AUR) and Prescription Intervention Service. The MUR and AUR services provided by pharmacists are to help patients in the use of their medication and appliances. A MUR includes what each medicine is used for, side effects and if the patient has any problem taking them. The Prescription Intervention Service is in essence the same as the MUR service, but conducted on an ad hoc basis, when a significant problem with a patient’s medication is highlighted during the dispensing process.
Enhanced Services The following enhanced services that are currently commissioned, as at August 2014 by:
Public Health within the council:
Supervised consumption - This service requires the pharmacist to supervise the consumption of opiate substitute prescribed medicines at the point of dispensing in the pharmacy so ensuring that the dose has been administered to the patient.
Needle exchange - The pharmacy provides access to sterile needles and syringes, and sharps containers for return of used equipment. The aim of the service is to reduce the risk of blood borne infections that are prevalent in people who inject drugs.
Chlamydia Screening – Pharmacists supply Chlamydia Screening Postal Kits to any person aged between 15 and 24 upon request and will opportunistically offer Chlamydia Screening Postal Kits to young people attending the pharmacy who may be sexually active. This service aims to improve access to Chlamydia screening and so reduce the prevalence of Chlamydia.
Emergency Hormonal Contraception - Pharmacists supply Emergency Hormonal Contraception (EHC) also known as the ‘morning after pill’, when appropriate to patients in line with the requirements of a locally agreed Patient Group Direction (PGD).
Smoking Cessation Services – Working with the main provider of Smoking cessation services pharmacies provide a range of support including medication to people who want to give up smoking.
NHS Health Checks - Pharmacies are commissioned to deliver NHS health checks to anyone aged 40 – 74, who does not have an existing cardiovascular condition. This provides the individual with an assessment of their risk on developing heart disease and allows signposting to GP follow up or health promotion services e.g. weight reduction / smoking cessation
The CCGs within Berkshire:
Palliative Care Urgent Drugs Scheme - making available locally a list of medication that may be required urgently for palliative care patients. A number of pharmacies ensure they keep the items in stock and can be accessed out of hours if required.
Advice to care homes is not available through community pharmacy but is provided by the medicines management teams in each CCG. This service provides support to staff within care homes, over and above the Dispensing Essential Service, to ensure the proper and effective ordering of drugs and appliances and their clinical and cost effective use, their safe storage, supply and administration and proper record keeping. This service is to improve patient safety within the care home and to ensure the safe storage, supply and administration of medicines.
NHS England:
Flu Immunisation - A pilot scheme was developed to increase flu vaccination availability in high risk groups through community pharmacy. In 2014 this scheme is being extended across Berkshire.
Private Services:
Some pharmacies offer private services, which are not commissioned, but are available to customers for additional payment e.g. diabetes screening.
Current Pattern of Enhanced services For more details see Appendix 4.
Figure 21: Map of Pharmacies in Reading to show how many of the Basic Enhanced Services are provided
Other Service Providers Dispensing Contractors In addition to community pharmacies, to ensure access in defined rural areas (controlled localities) - GPs may provide dispensing services to patient who live more than 1.6km from a pharmacy. Reading however does not have any rural areas that meet the required definition and so Reading does not have any dispensing doctors
Out of area service providers
Residents can of course access pharmacies in other areas and Reading borders with the following Local Authorities:
Oxfordshire
Wokingham
West Berkshire
Pharmacy Access and Services One measure of accessibility is the number of patients that can get to a pharmacy within 20 minutes driving time (see Appendix 5). For Reading it can be seen that all of the population can access a pharmacist within this time.
Within Reading we have also mapped the access within 20 minutes walking time.
Figure 22: Population of Reading that can get to a pharmacy within a 20-minute walk time
In this analysis it can be seen that the there are two areas with limited accessibility: North West (part of Caversham Heights) and South West - however at this time the Southern area has limited housing. It is estimated that only 5,000 people cannot access a pharmacy under this much more stringent measure.
Opening Hours
A survey was undertaken of all pharmacists in Reading. 28 providers out of 33 providers took part on this survey. The following information is taken from the survey.
All respondents are open Monday to Friday between 6am and 11pm depending on the day of the week. 86% of providers are open on Saturdays, with 43% open on a Sunday. In addition Reading has three ‘100 hour per week’ pharmacists.
Consultation Facilities To deliver the advanced services e.g. medicines utilisation reviews and to potentially support patients with more knowledge on their illnesses and increase patient confidence in self care, pharmacist will need an area to provide this level of support in a confidential setting.
In Reading 79% of providers have wheelchair accessible consultation facilities, an additional 7% have a consultation space however it is not wheelchair accessible. Only 7% do not have consultation space available.
Advanced services Within Reading a significant number of pharmacies provide advanced services for medicines, though this is not the case for appliance care and customisation services.
Figure 23: Reading Pharmacy response to question about the provision of Advanced Services
